1. Field of Invention
This invention relates to methods and apparatus for providing suture in a passageway.
2. Discussion of Related Art
Providing a passageway in a body portion, such as a bone, is a common procedure in surgical repair. For example, tendon damage frequently requires surgery for repair, e.g., to reattach a torn or separated tendon to the bone to which the tendon would normally be attached. In some cases, reattachment of the tendon or other material is performed using a passageway through bone, i.e., a transosseous tunnel. For example, rotator cuff injuries typically involve damage to the rotator cuff tendon such that the tendon, or at least a portion thereof, requires reattachment to the humerus. FIG. 1 shows a schematic diagram of a humerus 1 and a portion of a rotator cuff tendon 2 that is normally attached to the head of the humerus. In one type of damage to the rotator cuff, the tendon 2 may detach or be partially torn from the humerus 1, such as that shown schematically in FIG. 2. Such damage may be repaired by reattaching the rotator cuff tendon to the humerus 1 by a suture or other fixation so that the body's normal healing processes can naturally effect reattachment of the tendon to the bone. One repair technique for reattaching the rotator cuff 2 to the humerus 1 involves forming a hole in the bone and fixing an anchor 101 at a margin between the articulating portion 11 of the humerus 1 and the humerus' greater tuberosity 12. A suture 102 is secured to the rotator cuff 2 and the anchor 101, and the suture 102 is tensioned so that the rotator cuff 2 is held in place close to the humerus 1. Thereafter, the body may reestablish the proper attachment of the rotator cuff 2 to the humerus 1.
In another repair technique, a passageway may be formed through the humeral head, e.g., extending from a point at the margin to a location on the lateral side of the humerus. U.S. Pat. No. 5,330,468 discloses a drill guide for forming such a passageway in the humeral head and subsequently feeding suture through the passageway. One end of a suture placed in the rotator cuff may be passed through the passageway, and another end of the suture may be extended around the greater tuberosity (or passed through another adjacent passageway in the bone), and the two ends joined together to secure the tendon in place.